Depression Treatment

• What is CBT (cognitive behavioural therapy)

  • starts with the patient and therapist carrying out an assessment to clarify the patients problem
  • jointly identify goals and build a plan to achieve them
  • main task is to identify where there might be negative / irrational thoughts that need challenging
• How does CBT work ?

  Works to challenge negative and irrational thoughts, the replace them with effective behaviours
• What is Ellis‘ CBT therapy called?

  • REBT (rational emotional behaviour therapy)
  • It resolves emotional and behavioural problems
• What does the D stand for in Ellis‘ ABCDEF model?

  Disputing, irrational thought and beliefs
• What does the E stand for in Ellis‘ ABCDEF model?

  Effects, of disputing and effective attitude to life
• What does the F stand for in Ellis‘ ABCDEF model?

  Feelings, that are produced
• What is logical disputing (REBT) ?

  Self defeating beliefs do not follow from the event
• What is empirical disputing (REBT) ?

  Self defeating beliefs are inconsistent with reality
• What is pragmatic disputing (REBT) ?

  The pointlessness of self-defeating beliefs
• What does effective disputing do?

  Changes self-defeating beliefs into more rational beliefs
• Strength - research support

  • Ellis claimed a 90% success rate for REBT, taking an average of 27 session to complete the treatment.
  • Cuijpers (2013) found that out of 75 studies CBT was far superior to no treatment.
• Weakness - research support counter point

  • Ellis said that the therapy wasn’t always effective
  • he suggested this could be because some patients did not put their revised beliefs into action
• Strength - support for behaviour activation

  • Babyak randomly assigned 156 depressed adults to four months of aerobic exercise, drug treatment or both.
  • All patients improved
  • six months later, the exercise group had lower relapse rates than the medication group, especially if they had continued with an exercise regime.
• Strength - combination with alternative treatment

  • Cuijpers found that CBT was especially effective when used with drug therapy
  • e.g. SSRI (antidepressant) may alleviate symptoms enough to allow the patient to focus on the demands of СВТ.
• Weakness - individual differences

  • Elkin (1985) states that CBT work less well with people who have high levels of irrational beliefs that are rigid/resistant to change.
  • Or when realistic stressors cannot be resolved by therapy.
  • The directness of REBT does not suit everyone
  • some people want to share their worries without expending the cognitive effort necessary for recovery.
  • In severe cases, clients may not be able to pay attention in a session
  • it is also suggested that CBT is not suitable for people with learning differences
• Weakness - high relapse rates

  Ali et al (2017) found 42% relapsed within 6 months of ending treatment, 53% within a year